Fast Track Programs

[medicineluva]

Hi,

Interested in academic cardiology.

Do you guys know where I can find a list of residency programs that participate in fast-track route? I understand you must apply for these after internship, but I would like to know which programs participate since not all of them do.

Also, do you know how competitive it is to fast-track? It seems there's not much you can do to boost your application within < 1 year of internship (i.e. research), so just wondering if those applying to fast-track have already thought about it during med school and planned ahead.

Last thing, I just want to clarify...when you fast-track, then you go into fellowship at the SAME institution that you're doing residency in right? you can't jump to a different place for fellowship?

Thanks!

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[Instatewaiter]

Hi,

Interested in academic cardiology.

Do you guys know where I can find a list of residency programs that participate in fast-track route? I understand you must apply for these after internship, but I would like to know which programs participate since not all of them do.

Also, do you know how competitive it is to fast-track? It seems there's not much you can do to boost your application within < 1 year of internship (i.e. research), so just wondering if those applying to fast-track have already thought about it during med school and planned ahead.

Last thing, I just want to clarify...when you fast-track, then you go into fellowship at the SAME institution that you're doing residency in right? you can't jump to a different place for fellowship?

Thanks!

We have someone in my residency who is fast-tracking into cardiology. I would recommend AGAINST fast-tracking if you are going into cards. You need that extra year to be more comfortable in the unit.

In terms of fast tracking: Rheum, Endo, Onc, fine. GI perhaps. Pulm/critical care probably not the greatest idea. Cards not a good idea unless you go to a program where the fellow is basically superfluous.

 

[Instatewaiter]

Last thing, I just want to clarify...when you fast-track, then you go into fellowship at the SAME institution that you're doing residency in right? you can't jump to a different place for fellowship?

Thanks!

Often, yes you go to the same institution but it is not required. The person I was mentioning above is actually doing his fellowship elsewhere.

2 others are fast tracking in my program as well this year, 1 renal and 1 GI. Of course they were practicing docs in Ireland before they did residency in the US so it's a bit of a different story than if you are 2 years post-med school.

 

[HoldTheCoffee]

I'm under the impression that most academic/university-affiliated IM programs will give you the option of applying for a fast-track position. Unfortunately, based on my own personal experiences, the actual process of applying is pretty heterogenous. Some programs don't let you apply right away and prefer that you make the decision in concert with a PD (or whoever ends up being your mentor) during your intern year. Others allow you to apply via ERAS. Most require additional letters of recommendation. Some will require additional personal statements/essays. Some state a preference for PhDs. Etc. etc. Structure is different at different places too-- some places hope to groom you to become faculty, others don't care and don't even guarantee you a fellowship spot.

I'm actually not sure how competitive it is to fast-track. It sounds like something that would be competitive in theory but my guess is that getting a fast-track position at a "top tier" place that also has a "top tier" fellowship in your specialty of interest is way harder than if you start looking at more middle-range places. No matter what though, my guess is that you need a decent amount of research experience to be seriously considered. Doesn't have to be PhD... if you took time off from med school or got insanely lucky with pubs, that could probably do it too.

 

[jdh71]

Ugh. Fast track is not supposed to be some kind of back door scheme into sub-specialties. Fast track is for those wanting to be academic researchers. If you don't want to spend your career doing RESEARCH then don't clutter up the fast track process with your application.

 

[HoldTheCoffee]

Ugh. Fast track is not supposed to be some kind of back door scheme into sub-specialties. Fast track is for those wanting to be academic researchers. If you don't want to spend your career doing RESEARCH then don't clutter up the fast track process with your application.

Yeah, that's also a good point, and probably the most important one. If you add up all the time it takes to "fast" track, it tends to be longer than just doing things the standard way because of all the extra time devoted to research. You should only apply if you are interested in academics and seriously enjoy research, other you're wasting everyone's time.

 

[gutonc]

Ugh. Fast track is not supposed to be some kind of back door scheme into sub-specialties. Fast track is for those wanting to be academic researchers. If you don't want to spend your career doing RESEARCH then don't clutter up the fast track process with your application.

The Cards program at my institution has suspended the Research Pathway (and fired 2 fellows) because of people using it for this.

 

[jdh71]

Yeah, that's also a good point, and probably the most important one. If you add up all the time it takes to "fast" track, it tends to be longer than just doing things the standard way because of all the extra time devoted to research. You should only apply if you are interested in academics and seriously enjoy research, other you're wasting everyone's time.

Exactly. Though I'd caveat and say it's more than just wanting "academics" - because we've all worked with amazing clinical faculty working in academics right? Well, not all of those guys are active researchers (probably most of them are not). Research. This is the key word. Are willing to sacrifice some salary and are willing to try and compete with the PhDs for money, writing grants, and working either in yoru lab or on your clinical project continuously? This is a question someone needs to clarify for themselves BEFORE applying for a fast track. Those who know they don't want a research career or are equivocal about it, need to understand they do themselves a disservice by cutting clinical time short if they are planning to go out into the community and practice - not that, that is a dirty word, "private practice", but you need the extra CLINCAL time, because the one thing you will realize and realize very quickly once you are done with training is that the years of residency and fellowship were really just the bare minimum needed to get you up to reasonable snuff to be able to make a go of it yourself. So, don't do yourself or your patients some kind of disservice by cutting clinical training short if you're planning on being a clinician! And it's because of what has just been said that these programs have a bias for the PhDs - these are people who have already put in a significant time committment (plus learning "research" from a straight MD background is really, really tough - I've had a lot of struggles in the lab, the learning curve is brutal, IMHO).

There are still a good number of regular academic fellowships that will allow you time to try out research in a significant way (6-12 months, maybe more) to see if you like research if you have an "interest" but aren't sure about doubling down on a research career. Those who know they simply want to be a clinician can find plenty of fellowship that will fit that bill.

 

[jdh71]

The Cards program at my institution has suspended the Research Pathway (and fired 2 fellows) because of people using it for this.

That's too bad really. Though I think perhaps in the past it's not been advertised enough as a RESEARCH pathway.

 

[gutonc]

That's too bad really. Though I think perhaps in the past it's not been advertised enough as a RESEARCH pathway.

Which is why I correct people every time they use "Fast Track." Nothing fast about it (other than your exit from Gen IM). People who do it for that reason are the same people who do MD/PhD for the free tuition. They usually get burned. ABIM requires that if you don't complete the full 3-4 years of research, you return and finish your 3rd year of medicine. You can get a waiver to do another clinical year in your subspecialty as well.

The 2 cards fellows who got booted from the program both did a GIM fellowship year and then fled the area. The IM PD didn't want them back as R3s.

 

[SillyGiraffe]

I applied to fast track and I have to agree with the sentiments above. If you're planning to be a clinician, don't do fast track. "Fast Track" is a misnomer - you spend at least +1 year longer than your counterparts who did the traditional IM + subspecialty fellowship. That's a $200-250k loss/year if you go this route.

For those of you worried that you won't match into a subspecialty: if you're competitive for fast track to begin with (i.e., you have publications), you are competitive for the subspecialty later. That's what I've been told by the residency and fellowship PDs. So don't take this route as a "back door" into the subspecialty; you don't need it.

Do fast track if you can't imagine your life without research, if you want the research mentorship (how to write successful grants and proposals, someone to nudge you if you're going wayside in your research trajectory, etc.), and if you're willing to compress 3 years of residency into 2. All of your cushy electives will be gone and filled with ABIM requirements. Imagine 2 years of hard rotations, because that's all you have time for.

 

[gutonc]

Do fast track if you can't imagine your life without research, if you want the research mentorship (how to write successful grants and proposals, someone to nudge you if you're going wayside in your research trajectory, etc.), and if you're willing to compress 3 years of residency into 2. All of your cushy electives will be gone and filled with ABIM requirements. Imagine 2 years of hard rotations, because that's all you have time for.

Mostly true. I did 3 years worth of wards and ICU months in 2 years...kind of sucked. I had a worse schedule as an R2 than as an intern.

 

[AlmostAnMD]

Is this a good idea for me, if I want to pursue a career as an academic cardiologist? I'd like to do clinical research and be faculty. Pretty much my only two goals at the moment.

I should finish up with about six publications before applying for ERAS, two of them first author. Only have a masters, not a PhD. Competition aside, would this be better suited for someone with my career goals?

EDIT: I don't want to JUST do research, I'd still like to be a clinician, too :/

 

[jdh71]

Is this a good idea for me, if I want to pursue a career as an academic cardiologist? I'd like to do clinical research and be faculty. Pretty much my only two goals at the moment.

I should finish up with about six publications before applying for ERAS, two of them first author. Only have a masters, not a PhD. Competition aside, would this be better suited for someone with my career goals?

EDIT: I don't want to JUST do research, I'd still like to be a clinician, too :/

Most physician scientists spend 20-30% of their time seeing patients. So, it's not like you won't do any clinical time.

It could be the kind of thing that would be right up your alley.

 

[AlmostAnMD]

Cool beans. I just discovered "research track" residencies existed a few days ago and saw this topic.

Now to just finish school, be back in a few years.